Cross-sectional area of the paraspinal muscles and its association with muscle strength among fighter pilots: a 5-year follow-up

Tuomas Honkanen,Tuomo Leino,Ville Haapamäki,Heikki Kyröläinen,Matti Mäntysaari,Liisa Kerttula,Janne Avela

doi:10.1186/s12891-019-2551-y

Tuomas Honkanen, Tuomo Leino + Show 5 more

Open Access

https://doi.org/10.1186/s12891-019-2551-y

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Abstract

BackgroundA small cross sectional area (CSA) of the paraspinal muscles may be related to low back pain among military aviators but previous studies have mainly concentrated on spinal disc degeneration. Therefore, the primary aim of the study was to investigate the changes in muscle CSA and composition of the psoas and paraspinal muscles during a 5-year follow up among Finnish Air Force (FINAF) fighter pilots.MethodsStudy population consisted of 26 volunteered FINAF male fighter pilots (age: 20.6 (±0.6) at the baseline). The magnetic resonance imaging (MRI) examinations were collected at baseline and after 5 years of follow-up. CSA and composition of the paraspinal and psoas muscles were obtained at the levels of 3–4 and 4–5 lumbar spine. Maximal isometric strength tests were only performed on one occasion at baseline.ResultsThe follow-up comparisons indicated that the mean CSA of the paraspinal muscles increased (p < 0.01) by 8% at L3–4 level and 7% at L4–5 level during the 5-year period. There was no change in muscle composition during the follow-up period. The paraspinal and psoas muscles’ CSA was positively related to overall maximal isometric strength at the baseline. However, there was no association between LBP and muscle composition or CSA.ConclusionsThe paraspinal muscles’ CSA increased among FINAF fighter pilots during the first 5 years of service. This might be explained by physically demanding work and regular physical activity. However, no associations between muscle composition or CSA and low back pain (LBP) experienced were observed after the five-year follow-up.

Highlights

A small cross sectional area (CSA) of the paraspinal muscles may be related to low back pain among military aviators but previous studies have mainly concentrated on spinal disc degeneration
It has been suggested that the side-to-side CSA asymmetries of the Honkanen et al BMC Musculoskeletal Disorders (2019) 20:170 lumbar paraspinal muscles associate with Low back pain (LBP) [10,11,12]
Hides et al [11] suggested that asymmetries of greater than 10% should be regarded as an abnormality, whereas Niemeläinen et al [13] found that the side-to-side paraspinal muscle asymmetries of greater than 10% is common among men without a history of LBP

Summary

Introduction

A small cross sectional area (CSA) of the paraspinal muscles may be related to low back pain among military aviators but previous studies have mainly concentrated on spinal disc degeneration. The cross-sectional area (CSA) of the paraspinal muscles, especially at the lowest level of the lumbar spine, has been found to be smaller in LBP patients compared to their healthy counterparts [10]. It has been suggested that the side-to-side CSA asymmetries of the Honkanen et al BMC Musculoskeletal Disorders (2019) 20:170 lumbar paraspinal muscles associate with LBP [10,11,12]. According to literature, it is, conflicting when asymmetries are diagnosed as an abnormality. Hides et al [11] suggested that asymmetries of greater than 10% should be regarded as an abnormality, whereas Niemeläinen et al [13] found that the side-to-side paraspinal muscle asymmetries of greater than 10% is common among men without a history of LBP

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